Pages

Wednesday, May 22, 2013

All about Eve

2013 marks the 30th anniversary of the discovery of the Human Immunodeficiency Virus (HIV), the virus that causes Aquired Immune Deficiency syndrome or AIDS.

AIDS was first described in 1981. A cluster of odd infections were noted particularly in intra venous drug users and gay men in the United States. Soon the number of affected individuals was increasing almost exponentially.

Frustratingly for doctors and researchers - nothing seemed to help these patients. The image below graphically (and graphically) demonstrates the sheer horror of the early years of the AIDS epidemic in the United States, with rising rates of infection and death rates hovering between 80 and 90%.

Effectively a diagnosis of AIDS invariably meant death.

Even worse the groups affected in the initial stage of the epidemic were known as the four "H's". Haemophiliacs, Homosexuals, Heroin users and Haitians. With the exception of those with haemophilia these groups were mostly the hidden underclasses.

By this stage hysteria had gripped the country. In 1983 the viral origin of the disease was known, alongside the routes of its transmission, but this didn't help matters. A news report of the death of four babies in Queensland after recieving contaminated blood from a homosexual donor resulted in an angry and violent mob and several attacks on gay men. NSW policemen refused to do breath tests fearing infection from saliva. Telecom workers refused to service a phone exchange in Pitt Street in Sydney reportedly due to the large number of gay men that worked there. One Australian airline even went so far as to ban HIV infected passengers from flying.

Perhaps the most prominent victim of this abuse was a small child named Eve Van Grafhorst.

Eve was born prematurely in 1982 and required multiple blood transfusions to save her life. Unfortunately it was the eleventh and final transfusion which would end her life, eleven years later from AIDS.

At the age of three, Eve's mother attempted to enrol her in childcare. The accompanying furore gripped the nations media. Parents of other children in the pre school went on the attack and threatened to withdraw their children if they were exposed to Eve, resulting in the pre school refusing enrollment. Eve's family were harrassed in the street and spat on.

Eventually Eve and her family were forced to move to New Zealand, where the epidemic was less impactful and the hysteria less.

She fortunately managed to live out the rest of her short life relatively normally.

All of this serves to demonstrate just how badly Australia as a nation could have responded to the epidemic. Overseas in the US the example was poor indeed, with little to no response from the government over the eight years of the Reagan administration. In that country AIDS research was chronically underfunded for several years, federal funding was denied to several gay AIDS groups for prevention programs and zealous right wingers in the republican party and amongst Reagan's own staff worked to enact a message that AIDS was a plague from God sent to punish homosexuals, culminating in George Bush, Reagan's vice president, openly campaigning for mandatory testing (but only for certain groups of people).

Reagan himself did not even mention the epidemic that by this stage had killed thousands of his citizens until October 1987. How many more people died because of his failure to act cannot be estimated but is surely huge.

Australia, by contrast, had one of the best and most effective responses in the world. There were calls for draconian measures such as compulsory testing for certain groups, isolation of infected individuals and shutting down so called 'high risk' areas such as gay bathhouses. Given the prevalant hysteria and latent homophobia of Australians these ideas had widespread public support.

Australia went a different way.

Granted public health authorities in Australia had a distinct advantage of those in the USA, with an 18 month lag time before the first case appeared here. However the success of the Australian response to HIV/AIDS was due to an entirely different approach to the US counterparts.

Firstly representatives of affected individuals were incorportated and funded in coordinating the response, the reasoning being that these groups were most likely to understand how to target those at risks. The response avoided abstenence and exclusion seen in other countries and focused on harm minimisation and emphasised that ALL Australians, not just marginalised groups such as sex workers, homosexuals and drug users were at risk.

By 1987 the federal government and every state and territory was running needle exchange programs and public health messages on the spread of HIV/AIDS and the importance of safe sex using condoms. Education programs were commenced in every state funded school (your author remembers this well). Seperate programs were run specifically targeting high risk groups, generally by those groups themselves. Perhaps the most memorable was the terrifying Grim Reaper ad campaign that ran on televisions Australia-wide.

This campaign was so successfully it ultimately meant that Australia effectively dodged the so called 'second wave' of HIV infections amongst those practicing heterosexual sex. The rate of new HIV infections began dropping off after 1984, stabilising at a rate of about 500 per year which is where we sit now.

Effective treatment for HIV was first approved in 1987 in the form of AZT. Multiple other medications joined later. In the Western World at least HIV has now moved from a life threatening infection to more of a chronic illness, akin to diabetes.

Unfortunately this is not the case in many developing countries. But that is a much longer story for another day.